Reliability and usefulness of random fecal alpha 1-antitrypsin concentration: further simplification of the method

The reliability of random fecal alpha 1-antitrypsin (FA-1-AT) concentration has been evaluated by comparing FA-1-AT values on random specimens and on concomitant 24-72 h fecal collections. In order to simplify the method, FA-1-AT data derived from lyophilized fecal samples were compared with those obtained from 37 degrees C heat-dried fecal samples. Random FA-1-AT concentration was assayed in 80 children with various gastrointestinal illnesses and 36 healthy age-matched controls. There was a close relationship between FA-1-AT values obtained from random samples and 1-day or 3-day collections. There was also a significant relationship between FA-1-AT values derived from the two different ways of drying the stools. Mean FA-1-AT values were statistically different when compared to the controls in the following groups of disorders: untreated and after-gluten-challenge celiac disease, post-enteritis syndrome, and cow's milk intolerance. The possible meanings of the abnormal FA-1-AT concentration in the various disorders are discussed. We conclude that FA-1-AT is a simple and reliable test for enteric protein loss. The simplification of the method proposed by us should reduce the cost of the test and moreover make it feasible in all laboratories.

Characterization of T cell subsets in patients with atopic dermatitis using OKT monoclonal antibodies

The distribution of T cell subsets has been studied by means of OKT monoclonal antibodies in 19 children with atopic dermatitis. In these patients a decreased percentage of circulating OKT4+ cells has been observed, while no difference has been found between atopic and normal subjects, regarding the percentages of circulating OKT8+ and OKT11+ cells. An increased OKT4+/OKT8+ ratio has been detected only in three children with a particularly severe and extensive atopic eczema.

Complement anaphylatoxins in idiopathic mixed cryoglobulinemia

Basophil activation, observed in patients with idiopathic mixed cryoglobulinemia, has been related to the complement anaphylatoxins C4a, C3a and C5a. In the present study the plasma levels of the complement anaphylatoxins have been evaluated in 21 patients affected with idiopathic mixed cryoglobulinemia. The plasma concentration of C3a desArg was significantly higher in the patients than in the healthy controls; conversely the plasma values of C4a desArg were significantly lower. C5a desArg was not detectable in plasma from any subject. The high plasma level of C3a desArg in our patients may suggest a role for C3a anaphylatoxin in 'in vivo' basophil activation. No correlation was found between the plasma concentrations of C3a desArg or C4a desArg, the amount of cryoprecipitate and the clinical activity of the disease.

[Papillomas and papillomatosis of the breast: clinical, diagnostic and therapeutic implications]

The authors describe the different clinical and histologic features of solitary papilloma, multiple papillary lesions and diffused papillomatosis, and point out the different surgical approach in the three forms described.

Conversion of longstanding atrial flutter to sinus rhythm and transient complete A-V block following oral administration of verapamil. Report of a case

In a patient with ischaemic heart disease chronic atrial flutter reverted to sinus rhythm during treatment with oral Verapamil, given at dosage of 240 mg once a day in order to prevent spontaneous angina. Such an unexpected event was accompanied by a remarkable sinus node depression and by a transient complete a-v block, that gradually subsides leaving a slight permanent a-v conduction delay. Either a higher bioavailability of the drug or an extremely increased sensitivity of the receptors can explain such a marked electrophysiological effect at a moderate drug dosage.

[Intolerance to rice: a food intolerance uncommon in children]

We report the first case, in our knowledge, of dietary intolerance only to the rice in childhood. Gastrointestinal symptoms and shock-like state in relation to the ingestion of ground rice were observed in a 5-month-old girl. At 34 months she was still clinically intolerant to this food.

Plasma of normal, but not atopic persons reducing basophil degranulation induced by anti-IgE

The response to anti-IgE serum of basophils from allergic and normal persons in the presence of whole plasma or as washed cells in Tyrode solution was examined to detect any inhibiting activity of human plasma. A factor reducing the potential of anti-IgE serum to degranulate basophils was present in plasma of normal but not of allergic persons. It is considered that this property of plasma could contribute to homeostatic control in immediate hypersensitivity.

Effect of verapamil on allergen-induced asthma in patients with respiratory allergy

Specific degranulation of mast cells and basophils depends upon transmembrane calcium flow. In the present studies the protective effect of the calcium-antagonist drug verapamil against allergen-induced asthma was assessed in eight atopic patients. The results of this study showed that verapamil, administered both orally or by aerosol, can prevent the specific bronchoconstriction.

Functional characterization of specific IgE antibodies for tetanus toxoid

The specific IgE response that appears in subjects immunized with tetanus toxoid does not induce hypersensitivity reactions at subsequent immunizations. The type I immune response, therefore, was studied both in vivo and in vitro, in 11 subjects who had specific IgE antibodies for tetanus toxoid. The results showed that: 1. the specific IgE antibodies are heterogeneous regarding their affinity for the mast cell and basophil receptors; 2. the specific IgG antibodies for tetanus toxoid, at serum concentrations, are not able to interfere with the in vitro specific basophil degranulation; 3. in the PEG precipitate there are aggregates of specific IgE antibodies for tetanus toxoid. In vitro, these molecular aggregates are not able to sensitize the basophil cells.

Clinical significance of specific IgE determination on nasal secretion

The clinical use of RAST on the nasal secretions was investigated in seventeen atopic patients, with asthma or rhinitis, who had shown at a first diagnostic screening, some difficulties in the identification of the responsible allergen(s). The results of the skin tests, of the RAST on the serum and on the nasal secretions and of the specific provocation test (bronchial or nasal) were compared. In some cases the basophil degranulation test was performed. The results of the RAST on the nasal secretions were in perfect agreement with the provocation test. The skin tests and the RAST on the serum showed many discrepancies, particularly for Dermatophagoides, epidermal derivatives of cat and dog and moulds, and less frequently for Graminaceae and other pollens. It is concluded that RAST analysis on nasal secretions is useful in clinical diagnosis of allergy especially for Dermatophagoides, epidermal derivatives and moulds. Most false positive results were observed with the RAST on serum; in fifteen cases it was positive, while all the other tests, basophil degranulation test included, were negative. The data suggest that IgE may have a low affinity for basophil receptors.

Basophil activation in idiopathic mixed cryoglobulinemia

We studied basophil activation in patients affected by idiopathic mixed cryoglobulinemia in order to investigate the role of the basophil cell in the pathogenesis of the vasculitis typical of this disease. We selected 13 patients and we performed the in vitro basophil degranulation test with cryoprecipitate; in 5 cases the test was positive when it was performed in whole blood, while it was negative when it was performed with cells washed and resuspended in Tyrode's buffer. In 6 subjects it was not possible to perform the test because of the very low number of circulating basophil cells. Finally, in 2 subjects the in vitro basophil degranulation test with cryoprecipitate was negative; this result may be related to the very low levels of complement factors in the sera of these subjects. These findings suggest that the pathogenetic mechanism of vasculitis in idiopathic mixed cryoglobulinemia could be started by basophil activation.